The Serum Uric Acid to Serum Creatinine Ratio is an Independent Risk Factor for Diabetic Kidney Disease

PURPOSE: A retrospective study was designed to evaluate whether the serum uric acid to serum creatinine ratio (SUA/SCr) can be used as an indicator of diabetic kidney disease (DKD) and macroangiopathy in patients with type 2 diabetes mellitus (T2DM). PATIENTS AND METHODS: We screened 2227 patients diagnosed with T2DM, and 450 patients were finally included. They were assigned to three groups based on the tertile of SUA/SCr (Group Tertile 1, Tertile 2, Tertile 3). Demographic information and biochemical parameters were collected from Electronic Patient Record (EPR). RESULTS: The estimated glomerular filtration rate (eGFR) values were lowest in Group Tertile 1 and highest in Group Tertile 3 (P < 0.05). There was no significant difference in urinary albumin creatinine ratio (UACR) among the three groups (P > 0.05). Partial correlation analyses revealed that SUA/SCr levels were significantly and positively correlated with eGFR, SUA, body mass index, gamma-glutamyl transpeptidase, alanine transaminase, triglycerides, C-peptide, high-density lipoprotein cholesterol and fatty liver, while they were negatively correlated with SCr, blood urea nitrogen, cystatin-c, age, male sex, DM duration and hypertension history (P < 0.05). Logistic regression analysis revealed that SUA/SCr was an independent risk factor for eGFR < 60 mL/min/1.73 m² (P < 0.05). The ROC curve showed that the cutoff value of SUA/SCr for the identification of eGFR < 60 mL/min/1.73 m² was 3.434. In patients with normal UACR, SUA/SCr levels of patients with eGFR < 60 mL/min/1.73 m² were lower than those with eGFR ≥ 60 mL/min/1.73 m² (P < 0.05). Regression analysis did not show SUA/SCr associate to macrovascular disease after adjusting for confounding factors. CONCLUSION: SUA/SCr is an independent risk factor for DKD in patients with T2DM and may be helpful for identifying normoalbuminuric DKD.